Work

Risk Factors and Outcomes for Children With Carbapenem-Resistant Enterobacteriaceae: A Multicenter Case Series

Year: 2016

Type: article

Abstract: Background. Carbapenem-resistant Enterobacteriaceae (CRE) are increasingly identified causes of healthcare-associated infections in adults, but little is known about CRE in children. Methods. Patients <21 years admitted to Children's Hospital of Philadelphia, Johns Hopkins Hospital, or Boston Children's Hospital with CRE isolated from clinical cultures between 2011 and 2015 were included. Data were obtained by medical record review and analyzed using descriptive statistics. Results. Sixty-two unique patients with CRE were identified. Enterobacter species were isolated most often, followed by Klebsiella species. Approximately half of isolates were tested for carbapenemase production and 61% were positive (Figure 1). Patient characteristics are shown in Table 1. Prior hospitalization (n = 31; 50%) and medical care abroad (n = 10; 16%) were common. Rates of recent broad-spectrum antibiotic use, including carbapenems (n = 23; 37%), were high. Combination therapy was prescribed infrequently and 60-day mortality was 11% (Table 2). Figure 1. Microbiology (n = 62). (A) Organism, (B). Source, (C)., Carbapenemase testing. Conclusion. Our study identifies several important risk factors for CRE in children and highlights key differences from adult patients, including a predominance of Enterobacter species, infrequent use of dual therapy, and substantially lower mortality. Baseline Clinical and Demographic Variables Treatment and Outcomes for Patients With CRE Infection Disclosures. All authors: No reported disclosures.

Source: Open Forum Infectious Diseases

DOI: 10.1093/ofid/ofw172.561